Back to basics about psychosocial factors and pain – iii

Last week I discussed some of the areas in the brain, and basic principles, that are currently thought to influence our pain experience. This week I thought I’d introduce one of my favourite ways of considering pain mechanisms, mainly because it helps me think through the four main kinds of mechanisms, and can influence our treatment approach. At this stage I want to raise my hand to acknowledge the following: My gratitude to Dr John Alchin, longtime friend and colleague, who first pointed this paper out to me and has shared it with hundreds of people who go to see him at the local tertiary pain management centre. We know this is a simplified, under-developed approach to mechanisms underpinning pain, but it’s helpful nevertheless. Most of our patients will have a combination of mechanisms involved in their experience, not just one. This approach to mechanisms doesn’t include the psychological or social – just the primary biological processes. Throughout this blog, when I use the word “pain” I mean the experience we have once whatever mechanisms involved filter up through to our awareness. So while I talk about peripheral mechanisms, they’re only experienced as pain once we become aware of them – and that process involves a whole lot of what I discussed in my last post . Clifford Woolf wrote this paper in 2010, and although the research into mechanisms has continued unabated, I think it provides clinicians with a reasonable gui...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Education Pain Pain conditions Research Science in practice biopsychosocial Chronic pain Health pain management Source Type: blogs

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CONCLUSIONS: These findings support the use of patient experiences and feedback to aide product development. In addition, post-9/11 veterans support the use of eScreening to assist health screening. However, evaluating the eScreening program in more diverse veteran groups and Veterans Affairs settings is needed to improve the generalizability of these findings to the larger veteran population. PMID: 32060553 [PubMed - as supplied by publisher]
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research
Authors: Teixeira JC, Jackson PJ Abstract Distinguishing between central and peripheral causes of vertigo can be challenging not only in an acute setting but also in chronic settings. A thorough review of systems and physical exam can assist providers in differentiating central versus peripheral etiologies and the need for urgent imaging. In this case, a 47-year-old man presented with vertigo, right-sided hearing loss, right-sided headache, and right-sided facial pain that began 4 weeks before while the patient was on a cruise ship. His physical exam findings were notable for anisocoria with right pupil 3.5 an...
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research
Publication date: Available online 15 February 2020Source: Toxicology ReportsAuthor(s): Hellen A. Oketch-Rabah, Amy L. Roe, Cynthia V. Rider, Herbert L. Bonkovsky, Gabriel I. Giancaspro, Victor Navarro, Mary F. Paine, Joseph M. Betz, Robin J. Marles, Steven Casper, Bill Gurley, Scott A. Jordan, Kan He, Mahendra P. Kapoor, Theertham P. Rao, Averell H. Sherker, Robert J. Fontana, Simona Rossi, Raj Vuppalanchi, Leonard B. SeeffABSTRACTAs part of the United States Pharmacopeia’s ongoing review of dietary supplement safety data, a new comprehensive systematic review on green tea extracts (GTE) has been completed. GTEs may...
Source: Toxicology Reports - Category: Toxicology Source Type: research
Life after opioids: 'We have not served our patients well' More than 3 million Australians are living with chronic pain, and the medical system is struggling to help them as it turns away from its reliance on opioids www.theguardian.com “You may have a patient that has been on a stable dose of opioids for 10 years, and then you start de-prescribing. We are now exposing them to new risks for opioid overdose, for suicidality, for actual suicide, for withdrawal symptoms, for increased pain.” People living in chronic pain are a hi...
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
AbstractAerophagia is a functional gastrointestinal disorder characterized by excessive swallowing of air associated with abdominal distension and pain, flatulence, belching, nausea, and vomiting. The purpose of the current study was to evaluate the effectiveness of an antecedent-based behavioral intervention on aerophagia with an adolescent female diagnosed with Lennox-Gastaut syndrome (LGS), severe intellectual disability, and herpes simplex virus infection of the central nervous system with chronic static encephalopathy. Results from a functional analysis and multiple-component aerophagia assessment suggested that aerop...
Source: Journal of Developmental and Physical Disabilities - Category: Disability Source Type: research
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Source: Journal of Psychosocial Oncology - Category: Cancer & Oncology Authors: Source Type: research
Publication date: Available online 15 February 2020Source: Blood Cells, Molecules, and DiseasesAuthor(s): Brande Brown, Kathleen Long, Levon Agdere, Jolanta Kulpa, Sara Zarzoso-Fernandez, Deepak Choudhary, Revathy SundarumAbstractBackgroundWhile there is a known association between low vitamin D levels and increased chronic pain in patients with Sickle Cell Disease (SCD), there are no reported studies evaluating the relationship of vitamin D levels and hospitalization outcomes in this population. The aim of this study was to assess this relationship with hospitalization outcomes defined as the number of emergency room (ER)...
Source: Blood Cells, Molecules, and Diseases - Category: Hematology Source Type: research
Source: Journal of Pain Research - Category: Anesthesiology Tags: Journal of Pain Research Source Type: research
Source: Journal of Pain Research - Category: Anesthesiology Tags: Journal of Pain Research Source Type: research
Authors: Oliveira A, Simões S, Ascenso A, Reis CP Abstract Wound healing is a complex physiological process that occurs in the human body involving the sequential activation of multiple cell types and signaling pathways in a coordinated manner.Chronic wounds and burns clearly decrease quality of life of the patients since they are associated with an increase in physical pain and socio-economical complications. Furthermore, incidence and prevalence of chronic wounds (unlike burns) have been increasing mainly due to population aging resulting in increased costs for national health systems. Thus, the developmen...
Source: Journal of Dermatological Treatment - Category: Dermatology Tags: J Dermatolog Treat Source Type: research
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